*This article discusses suicidal behaviour. If you have questions on self-harm or feel suicidal, use this link to find an international helpline – https://findahelpline.com/.*
A new study from the National University of Malaysia has provided early evidence that the country’s 2020 ban on a deadly pesticide has helped to save lives.
Pesticide poisoning is the second most common method of suicide in Malaysia. Global evidence shows that national bans on highly toxic pesticides are the most effective way to prevent deaths from pesticide self-poisoning.
A highly hazardous pesticide
In January 2020, Malaysia introduced a total ban on paraquat – a highly hazardous pesticide responsible for a high number of deaths in the country.
The study aimed to evaluate the effectiveness of the national paraquat ban in reducing deaths. It examined data from two Malaysian hospitals, from different agricultural states in the East and West of the country.
It found that, after the paraquat ban, the proportion of pesticide poisoning cases using paraquat decreased from 36% to 24%. There was also a reduction in deaths, with the overall case-fatality falling from 21% to 17%.
This is not the first time that Malaysia has banned paraquat. A ban was announced in 2002, with a phase-out by June 2005. This resulted in a slight drop in paraquat poisoning. However, the ban was rescinded in 2006, leading to a five-fold increase in the number of paraquat poisoning cases.
Professor Lai Fong Chan, Associate Professor and Consultant Psychiatrist at the National University of Malaysia, who led the study, said:
“This study importantly shows that a national ban of paraquat was effective in significantly reducing paraquat poisoning and potentially reduced mortality from paraquat poisoning in Malaysia. Future longitudinal studies are now required to examine the long-term impact of the implementation of the national paraquat ban as well as sustainable alternatives to highly hazardous pesticides.”
Characteristics of patients
The study also examined the characteristics of pesticide poisoning patients in Malaysia. It found that 76%, a large majority, were self-poisoning cases – where people had intentionally ingested the pesticide.
Furthermore, 75% of pesticide self-poisoning were suicidal in nature, 62% of cases had socio-environmental stressors, such as domestic conflicts. Of the pesticide poisoning patients who survived, 42% had a psychiatric diagnosis.
These findings support existing international evidence that many suicide attempts and acts of self-harm are impulsive. They often happen in moments of crisis or intense psychological distress. If a person does not have access to a lethal means of suicide during this period of crisis, they are more likely to survive.
Dr Leah Utyasheva, Policy Director at the Centre for Pesticide Suicide Prevention, which supported the study, said:
“These findings are extremely promising and add to a growing body of evidence that bans on highly hazardous pesticides, such as paraquat, are the most effective way to prevent deaths from self-poisoning. With safer alternatives available to farmers, there is no need for their existence. Paraquat is a highly dangerous pesticide with no known antidote.
“Responsibility for exposure and poisoning should not lie with farmers living in vulnerable, rural communities. They are often unable to understand the labels on bottles and lack resources such as personal protective equipment (PPE). Governments must therefore take action, as Malaysia has done, to ban this deadly pesticide and protect their people from harm.”
The full findings from the study are published in BMC Psychiatry